USACHPPM HEALTH INFORMATION OPERATIONS (HIO) UPDATE 18 October 2002

The HIO Update provides information regarding global medical and veterinary issues of interest to the United States (US) Army. The update does not attempt to analyze the information regarding potential strategic or tactical impact to the US Army and as such, should not be regarded as a medical intelligence product. Medical intelligence products are available at http://mic.afmic.detrick.army.mil/. The information in the HIO Update should provide an increased awareness of current and emerging health-related issues.

HOT ISSUES ....................................................................................................................... 2
Company Reports Successful Animal Trial of Vaccine for Marburg Virus ........................... 2 Duct Tape Can Get Rid of Warts: Study................................................................................. 2 Early Treatment Keeps Glaucoma in Check ........................................................................... 2 First World Report on Violence and Health............................................................................ 3 NASA Researchers Developing Tools to Help Track and Predict West Nile Virus............... 3 National Lead Poisoning Prevention Week ............................................................................ 3 Potato Powder Stops Bleeding, May Help Surgery ................................................................ 3 Recommended Adult Immunization Schedule Published....................................................... 4 Study: Dietary Supplement May Slow Parkinson's ................................................................ 4 Toxic Weapons Testing on US Forces During Cold War More Widespread than Previously Known ..................................................................................................................................... 4 Treating High Blood Pressure May Stave Off Dementia........................................................ 5

USEUCOM ........................................................................................................................... 5
Cyclosporiasis Outbreak in Germany Associated with the Consumption of Salad ................ 5 Environmental Health Risk Assessment: Macedonia ............................................................. 5 Environmental Health Risk Assessment: Moldova................................................................. 5 Environmental Health Risk Assessment: Serbia and Montenegro.......................................... 5 Environmental Health Risk Assessment: Syria....................................................................... 5 Environmental Health Risk Assessment: Tunisia ................................................................... 6 Public Health Services Need Urgent Help to Combat Humanitarian Crisis in Southern Africa, World Health Organization Tells Donors ................................................................... 6

USCENTCOM .................................................................................................................... 6
Malaria Distribution in the Iraq Region .................................................................................. 6 Malaria in Kyrgyzstan............................................................................................................. 6 Venomous Snakes and Scorpions in Iraq, and Their Antivenin Sources................................ 7

USJFCOM .............................................................................................................................. 7
Anemia Common in Kids in Federal Nutrition Program ........................................................ 7 Bacteria Fears Prompt Largest Ever U.S. Meat Recall ........................................................... 7 Iron Deficiency --- United States, 1999--2000........................................................................ 7

USPACOM ............................................................................................................................ 8
Dengue Fever in Taiwan ......................................................................................................... 8 -1-

Environmental Health Risk Assessment: China, Northern ..................................................... 8 Environmental Health Risk Assessment: Malaysia ................................................................ 8 Environmental Health Risk Assessment: Philippines ............................................................. 8

USSOUTHCOM................................................................................................................ 8
Curtains with Insecticide Reduce Rates of Cutaneous Leishmaniasis.................................... 8

HOT ISSUES
Company Reports Successful Animal Trial of Vaccine for Marburg Virus
7 October - CIDRAP reported GenPhar, Inc., a biopharmaceutical company based in South Carolina, announces that its vaccine for the highly lethal Marburg virus was 100% effective in initial animal trials. In the tests, conducted by the US Army Medical Research Institute of Infectious Diseases, vaccinated animals were fully protected against a "very severe challenge with highly concentrated Marburg virus," the company says. GenPhar Inc. intends to make this Marburg vaccine available to the Army and the Department of Health and Human Services in a relatively short period of time. The Marburg virus causes a hemorrhagic fever and is considered a potential tool for bioterrorists. View Original Report

Duct Tape Can Get Rid of Warts: Study
14 October - Reuters reported on a small study where application of duct tape successfully removed warts. According to the findings of a small study in children, applying duct tape to the common wart (scientifically known as Verruca vulgaris) appears to be superior to traditional cryotherapy with liquid nitrogen. The investigators found that 85% of those in the duct tape group, compared to 60% of those in the cryotherapy group "had complete resolution of their warts”. The report is published in the October issue of the Archives of Pediatric and Adolescent Medicine. SOURCE: Archives of Pediatric and Adolescent Medicine 2002;156:971-974. View Article

Early Treatment Keeps Glaucoma in Check
14 October - Reuters reports on a study where early treatment to reduce pressure in the eye can slow the progression of glaucoma. The study is the first "definite proof" that lowering intraocular pressure early in glaucoma can slow the deterioration caused by the disease, the study's lead author, Dr. Anders Heijl of Malmo University Hospital in Sweden, told Reuters Health. But he cautioned that the encouraging results of the study "do not mean that all glaucoma patients should receive maximum treatment." The study included 129 patients who underwent laser surgery and took pressure-reducing eye drops and a "control" group of 126 patients who did not receive any treatment. Glaucoma was less likely to progress in patients who underwent treatment, and when the disease did advance, it did so later than in untreated patients. A report on the findings is published in the October issue of the journal Archives of Ophthalmology. View Article

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First World Report on Violence and Health
11 October – The CDC reported the World Health Organization announced the release of the World Report on Violence and Health (WRVH). The report is the first comprehensive review of the problem of violence on a global scale. The goals of the report are to highlight the crucial role that public health has to play in addressing the causes and consequences of violence, to make the case that violence is preventable, and to raise awareness about the problem of violence globally. The report is available at http://www5.who.int/violence_injury_prevention. View MMWR Report

NASA Researchers Developing Tools to Help Track and Predict West Nile Virus
8 October – NASA reported NASA researchers are conducting Earth Science research that may one day allow public health officials to better track and predict the spread of West Nile Virus. Based on what is known about the disease, NASA centers, including the Goddard Space Flight Center, Greenbelt, Md., and Ames Research Center in Moffett Field, Calif., are researching methods to identify environmental indicators from data acquired on NASA Earth Observing Systems, packaged in ways that highlight factors relevant to West Nile Virus transmission. These efforts are in conjunction with federal, state and local public health agency initiatives. NASA is planning a joint public health and Earth Science peer review with agencies responsible for addressing national concerns on West Nile Virus. These agencies include the Centers for Disease Control and Prevention, National Institutes of Health, Environmental Protection Agency, United States Geological Survey and state health departments. View Original Report

National Lead Poisoning Prevention Week
11 October – The CDC reports October 20--26, 2002, is National Lead Poisoning Prevention Week. Childhood lead poisoning is the most preventable environmental disease in young children, but approximately 1 million children still have elevated blood lead levels. The aim of National Lead Poisoning Prevention Week is 1) to raise awareness about the importance of screening at-risk children aged 1--2 years and those aged 3--6 years who have not been previously screened and 2) to urge persons to take precautions to eliminate children's exposure to lead. As part of National Lead Poisoning Prevention Week, events such as state proclamations, free lead screenings, lead-awareness community events, and educational campaigns will be conducted nationwide. Information about National Lead Poisoning Prevention Week activities is available through state or local health departments. Additional information about preventing childhood lead poisoning is available at http://www.cdc.gov/nceh/lead/lead.htm or by telephone, 800-424-5323. View MMWR Report.

Potato Powder Stops Bleeding, May Help Surgery
15 October - Reuters reported on new research where a powder made from the common potato appears to help blood to clot, closing minor cuts and aiding surgical procedures. Once dabbed on a cut, the powder acts as a "sponge" that mops up blood. The powder triggers an initial clotting mechanism and then the normal clotting process takes over and amylase, a type of enzyme, dissolves the powder away. The powder, approved by the FDA, consists of purified potato starch milled into spherical particles. It has been approved for sale over-the-counter, under the brand name of Bleed-Ex, and will reach shelves over the next few months. The

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coagulant might have military applications also. Bleed-Ex may free medics to attend to other duties instead of spending time applying pressure to wounds. View Article

Recommended Adult Immunization Schedule Published
11 October – The CDC reported in February 2002, the Advisory Committee on Immunization Practices (ACIP) approved for the first time a schedule for the routine vaccination of persons aged >19 years. The American Academy of Family Physicians (AAFP) and the American College of Obstetricians and Gynecologists (ACOG) have accepted the Adult Immunization Schedule. ACIP will review and approve annually both the recommended adult and childhood immunization schedules. Together, these schedules provide a comprehensive summary of recommendations for prevention of vaccine-preventable diseases during the life span of persons in the United States. A printable, annotated, color version of the schedule is available at http://www.cdc.gov/nip/recs/adult-schedule.pdf. Additional information on adult immunization and ordering instructions for Increasing Adult Vaccination Rates: What Works, a CD-ROM-based continuing education program offering primary-care providers strategies for increasing vaccination rates among their adult patients are available at http://www.cdc.gov/nip/. View MMWR Report

Study: Dietary Supplement May Slow Parkinson's
14 October – The Associated Press reports on a small but promising study where an over-thecounter dietary supplement may slow the progression of Parkinson's disease. The new study found evidence that a naturally occurring compound, coenzyme Q-10, or CoQ10, may help stop the nerve cell death that characterizes Parkinson's. The study involved 80 people. Half ate wafers containing various CoQ10 doses and half took a placebo for up to 16 months. By the study's end, the 23 patients on the highest daily doses had 44 percent less decline in mental function, movement and ability to perform daily living tasks than the placebo group. Lead author Dr. Clifford Shults at the University of California at San Diego and colleagues cautioned that there is not enough proof to recommend that Parkinson's patients use the supplement. But the findings are "tremendously encouraging," Shults said. The study appears in October's Archives of Neurology. View Article

Toxic Weapons Testing on US Forces During Cold War More Widespread than Previously Known
9 October – CIDRAP reported the House Veterans Affairs Subcommittee on Health is briefed in closed session on newly declassified Pentagon reports that the United States conducted wider testing than previously disclosed of chemical and biological weapons on its forces during Cold War–era military exercises. The reports describe how exercises used deadly substances like VX and sarin on American soil and in Canada and Britain to test the vulnerability of American forces to unconventional attack. The tests were not aimed at studying the weapons' effects on human health but rather at determining how the weapons would be affected by climate, environment, and other combat conditions. Rep. Christopher H. Smith, R.-N.J., demanded that assistance be made available to any veteran whose health was affected by the testing. Pentagon officials say there is no indication that the lethal chemical agents dispersed into the general population. View Original Report, View DoD Report, View SHAD Report

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Treating High Blood Pressure May Stave Off Dementia
14 October - Reuters reports on two new studies where medications to lower blood pressure may help stave off dementia and Alzheimer's disease. One, a large European trial, found that anti-hypertensive medications reduced the risk of dementia by 55% among patients who initially had high blood pressure, according to the report published in the Archives of Internal Medicine. A second study published in the same journal found that blood-pressure lowering drugs were associated with a decrease in the risk of mental decline in elderly African Americans. SOURCE: Archives of Internal Medicine 2002;162.View Article

USEUCOM
Cyclosporiasis Outbreak in Germany Associated with the Consumption of Salad
11 October – Medscape relays a report from Emerging Infectious Diseases on an outbreak, the first food borne cyclosporiasis outbreak reported from central Europe. The illness was reported in 34 persons who attended luncheons at a German restaurant. The overall attack rate was 85% (34/40). The only foods associated with significant disease risk were two salad side dishes prepared from lettuce imported from southern Europe and spiced with fresh green leafy herbs (p=0.0025). Cyclosporiasis typically has onset after an incubation period of approximately 1 week and is characterized by protracted and often relapsing gastroenteritis. View Article

Environmental Health Risk Assessment: Macedonia
7 October – AFMIC issued an environmental health risk assessment on Macedonia. The indepth report can be viewed at https://mic.afmic.detrick.army.mil under “What’s new.”

Environmental Health Risk Assessment: Moldova
7 October – AFMIC issued an environmental health risk assessment on Moldova. The in-depth report can be viewed at https://mic.afmic.detrick.army.mil under “What’s new.”

Environmental Health Risk Assessment: Serbia and Montenegro
8 October – AFMIC issued an environmental health risk assessment on Serbia and Montenegro. The in-depth report can be viewed at https://mic.afmic.detrick.army.mil under “What’s new.”

Environmental Health Risk Assessment: Syria
8 October – AFMIC issued an environmental health risk assessment on Syria. The in-depth report can be viewed at https://mic.afmic.detrick.army.mil under “What’s new.”

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Environmental Health Risk Assessment: Tunisia
8 October – AFMIC issued an environmental health risk assessment on Tunisia. The in-depth report can be found at https://mic.afmic.detrick.army.mil under “What’s new.”

Public Health Services Need Urgent Help to Combat Humanitarian Crisis in Southern Africa, World Health Organization Tells Donors
7 October – The World Health Organization (WHO) reported four months after the first warnings of an imminent humanitarian catastrophe in Southern Africa, several hundred thousand people may die because funds to provide basic relief for those who suffer have not been raised. In the worst affected countries - Malawi, Zimbabwe, Zambia, Lesotho and Swaziland - As many as 300,000 malnourished people may die of diseases they might otherwise fight off, had they been given a minimum of food and basic health care. According to the latest estimates, it now threatens the lives of nearly 14.5 million people. Urgent and priority health needs, including clean water and sanitation, therapeutic feeding, accessible and effective health care, must be addressed - and quickly, the agency says. Rapid response teams for detecting and tackling disease outbreaks, and responding to malnutrition, are already working within the affected countries. View Article

USCENTCOM
Malaria Distribution in the Iraq Region
11 October – AFMIC reported the Malaria distribution in the Iraq region. A map that shows the distribution of malaria cases as well as a table that outlines country-specific information on anticipated malaria risk level to US forces, seasonality, malaria species, and drug resistance, see can be found at https://mic.afmic.detrick.army.mil/ under “What’s New.” Additional details on malaria and other infectious disease risks are provided in the AFMIC Infectious Disease Risk Assessment published for each of the countries.

Malaria in Kyrgyzstan
9 October – AFMIC has updated their Malaria report for Kyrgyzstan. The in-depth report can be viewed at https://mic.afmic.detrick.army.mil under “What’s new.”

Red Crescent Helps Iraqi Polio Eradication Drive
11 October – The International Federation of Red Cross and Red Crescent Societies reported that in late September, about 700 International Red Crescent Society (IRCS) volunteers took part in a four-day campaign for poliomyelitis eradication organized across the country in partnership with the Iraqi Ministry of Health, the World Health Organization (WHO) and the United Nation's Children's Fund, (UNICEF)."Our mission is to assist in registering children when they are vaccinated through home visits or at health centers, and then to make sure that all children in a given neighborhood are covered," explains Al-Jiburi, a doctor with IRCS. Leaflets explaining what polio is and how to avoid being infected by the virus are also handed out.

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Efforts to eradicate polio from Iraq were intensified during 2000, after 77 cases were reported around the country the previous year. The Ministry of Health reported only four polio cases in 2000, and there have been none since. View Article

Venomous Snakes and Scorpions in Iraq, and Their Antivenin Sources
8 October – AFMIC issued a report specifying the venomous snakes and scorpions that inhabit Iraq as well as the best manufacturer from which to obtain related antivenins. The in-depth report including pictures of and information on each poisonous snake and scorpion is available at https://mic.afmic.detrick.army.mil under “What’s new.”

USJFCOM
Anemia Common in Kids in Federal Nutrition Program
15 October - Reuters reports on a study where many infants and children enrolled in a federal nutrition program for poor US families still suffer from iron deficiency anemia. The program, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), has been previously shown to reduce iron-deficiency anemia in youngsters, because it provides poor families with iron-fortified formula and cereal and vouchers for other iron-containing foods for their nutritionally at-risk children. But the new study findings suggest that the program may be less effective than previously thought. The study found that the younger infants--aged 6 to 8 months--were roughly three times more likely to be anemic than the older 3- to 5-year olds. The source of this article is in Archive of Pediatric and Adolescent Medicine 2002;156;1028-1032. View Article

Bacteria Fears Prompt Largest Ever U.S. Meat Recall
14 October – ProMED reports poultry processor Pilgrim's Pride is recalling 27.4 million pounds of cooked sandwich meat after warnings of possible contamination from Listeria monocytogenes, the largest meat recall in US history. The company pulled 295,000 pounds of turkey and chicken products Wednesday 9 Oct 2002, but expanded the recall over the weekend after tests came back positive for a strain of the potentially fatal bacteria. The nationwide recall covers meat processed at the company's plant in suburban Franconia from 1 May through 11 Oct 2002. Listeria can cause high fever, severe headache, neck stiffness and nausea, according to the USDA. It can be fatal in young children, the elderly and people with weak immune systems and can cause miscarriages and stillbirths. View Article CDC Listeria/ Prevention Site

Iron Deficiency --- United States, 1999--2000
11 October – The CDC reported that to characterize the iron status of persons in the United States, CDC calculated the prevalence of iron deficiency and iron deficiency anemia by analyzing data from the 1999--2000 National Health and Nutrition Examination Survey (NHANES 1999--2000). The estimated prevalence of iron deficiency was greatest among toddlers aged 1--2 years (7%) and adolescent and adult females aged 12--49 years (9%--16%).

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The prevalence of iron deficiency was approximately two times higher among non-Hispanic black and Mexican-American females (19%--22%) than among non-Hispanic white females (10%). To prevent iron deficiency, vulnerable populations should be encouraged to eat iron-rich foods and breast-feed or use iron-fortified formula for infants. View MMWR Report.

USPACOM
Dengue Fever in Taiwan
9 October – AFMIC has updated their Dengue Fever reports for Taiwan. The in-depth report can be viewed at https://mic.afmic.detrick.army.mil under “What’s new.”

Environmental Health Risk Assessment: China, Northern
10 October – AFMIC has issued an environmental health risk assessment for northern China. The in-depth report can be found at https://mic.afmic.detrick.army.mil under “What’s new.”

Environmental Health Risk Assessment: Malaysia
7 October - AFMIC has issued an environmental health risk assessment for Malaysia. The indepth report can be found at https://mic.afmic.detrick.army.mil under “What’s new.”

Environmental Health Risk Assessment: Philippines
8 October – AFMIC has issued an environmental health risk assessment for Philippines. The indepth report can be viewed at https://mic.afmic.detrick.army.mil under “What’s new.”

USSOUTHCOM
Curtains with Insecticide Reduce Rates of Cutaneous Leishmaniasis
12 October – The British Medical Journal (BMJ) reported pyrethroid impregnated curtains provide good protection against indoor transmission of leishmaniasis in urban Venezuela. Kroeger and colleagues carried out a community randomized trial in urban areas, where indoor transmission of cutaneous leishmaniasis is common. The intervention households were provided with curtains impregnated with insecticide, and the controls had ordinary curtains or none at all. After 12 months, the cumulative incidence of leishmaniasis in the intervention group had fallen from 4% to 0%, whereas in the control group it had increased to 9%. The number of sand flies entering houses was reduced in houses with impregnated curtains. View Abstract

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Please contact the below-listed POC for suggested improvements and/or comments regarding this report. This report is also available on the USACHPPM website at http://chppm-www.apgea.army.mil/Hioupdate/. POC: Rachel Gross, PhD Rachel.Gross@APG.amedd.army.mil Lorraine Bell, DrPH, MSN Lorraine.Bell@APG.amedd.army.mil

Approved: Kevin Delaney Chief, Health Information Operations (410) 436-5217 or DSN 584-5217

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ACRONYMS
AFMIC - Armed Forces Medical Intelligence Center BBC – British Broadcasting Company BMJ – British Medical Journal BSE – Bovine Spongiform Encephalopathy CIDRAP – Center for Infectious Disease Reasearch and Policy CDC – Centers for Disease Control and Prevention CNN – Cable News Network EPA – Environmental Protection Agency FDA – Food and Drug Administration IRIN - Integrated Regional Information Networks, part of the UN Office for the Coordination of Humanitarian Affairs (OCHA). MMWR – Morbidity and Mortality Weekly Report NASA – National Aeronautic and Space Association NIH – National Institute of Health WHO – World Health Organization

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